Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME69589 | FL |
NPI | 1124069992 |
---|---|
Provider Name | Esteban Martin Kloosterman |
First Address | Fort Lauderdale, FL 33308-3725 |
Second Address | Fort Lauderdale, FL 33308-3725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1036211 | CARE PLUS (01) | FL |
2593589 | GHI (01) | FL |
293291 | AVMED (01) | FL |
46454 | FL BC/BS (01) | FL |
G91047 | (02) | FL |